After Mastectomies, an Unexpected Blow: Numb New Breasts

Plastic surgeons performed more than 106,000 breast reconstructions in 2015, up 35 percent from 2000. And they have embraced cutting-edge techniques to improve the appearance of reconstructed breasts and give them a more natural “look and feel” — using a woman’s belly fat to create the new breast, sparing the nipple, minimizing scarring with creative incisions and offering enhancements like larger, firmer lifted breasts.

Doctors often promise patients that their reconstructed breasts will look even better than the breasts they had before. But they often describe the potential consequences of the surgery in ambiguous terms. Women say the fact that sensation and sexual arousal will not be restored is not made clear.

The main problem is using the word “feel,” said Dr. Clara Lee, an associate professor of plastic surgery at Ohio State University who does reconstructive breast surgery. Surgeons who use a woman’s own tissue to recreate a breast might tell the patient that it will “feel” like a natural breast, referring to how it feels to someone else, not the woman.

“We don’t always mean what’s important to the patient,” Dr. Lee said.

“Our focus has been on what women look like,” said Dr. Andrea L. Pusic, a plastic surgeon at Memorial Sloan Kettering Cancer Center who specializes in breast reconstruction and studies patients’ quality of life after breast surgery. “What it feels like to the woman has been a kind of blind spot in breast surgery. That’s the next frontier.”